螺旋CT诊断周围型肺癌与E钙黏蛋白研究

The Study on the correlation of Spiral CT features with expression of E-cad in peripheral pulmonary carcinoma

目的探讨周围型肺癌螺旋CT征象与E钙黏蛋白(E-cad)表达间的关系。方法对58例周围型肺癌患者行螺旋CT扫描,所有病例均经手术或穿刺病理证实,术后标本采用免疫组织化学SP法检测肿瘤组织中E-cad蛋白表达。将螺旋CT征象与E-cad蛋白表达进行对照。结果58例周围型肺癌中,螺旋CT判断胸膜侵犯准确率为86.67%,淋巴结转移准确率为88.24%,TNM分期的准确率为81.25%,E-cad异常表达率为55.17%。肺癌的E-cad异常表达与胸膜侵犯、淋巴结转移、肿瘤大小、棘突征明显相关(P<0.05),而与毛刺征、血管集中征、空洞征、胸膜凹陷征、分叶征无关(P>0.05)。结论螺旋CT可清晰显示周围型肺癌的各种征象,较准确地反映肿瘤浸润转移的病理学和生物学特性,指导临床选择适当治疗方案和预后的判断。

Objective To investigate the correlation of Spiral CT features with expression of E -cad in peripheral pulmonary carcinoma （PPC）. Methods Spiral CT scan were performed in 58 patients with PPC which confirmed by pathology, Expression of E - cad in 58 cases were examined with SP immunohistoehemical techniques. Spiral CT findings were compared with expression of E - cad. Resuits On Spiral CT scan, the accuracy in diagnosing invasion of pleural and detecting for lymph node metastasis was 86. 67% and 88.24% respectively, whereas the accuracy of staging in TNM was 81.25% ,The abnormal expression rate of E - cad was 55. 17%. The abnormal expression of E - cad was associated with the CT features, such as lymph node metastasis, pleural invasion and the size of tumor（ P 〈0. 05）, but was not related to cavity sign, spicular sign, vessel convergence sign, et al. （P 〉 0. 05） . Conclusion Spiral CT can clearly show all kinds of signs of PPC and accurately re- veal the pathological and biological characteristics of invasion and metastasis in PPC, and then to guide clinical therapy and prognosis.